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Receiving a breast cancer diagnosis will result in a person experiencing many different types of feelings: shock, fear, anxiety and anger to name but a few. All of a sudden, an uncertain future faces them and their mortality is staring them in the face. The research suggests that a breast cancer diagnosis brings more distress for women than other diagnoses, often leading to anxiety, even if good outcomes are expected. (Ashley Olivine, PhD, MPH)
They will grieve the sudden loss of their health. Elisabeth Kubler-Ross has written extensively about grief and described five stages a person may experience as they struggle to cope with loss. They are as follows:
1 Denial: The person is aware of their diagnosis, but not ready to “go there”. This can last for a while. I believe it is nature’s way of helping one cope with distressing news on the short term.
2 Anger: The person can become angry that this has happened to them, the underlying fear causing them to become reactive and unable to cope with the enormity of it all.
The anger will ebb and flow for a while as they try to adjust to their new world of tests, treatments, follow-ups and ongoing results.
3 Bargaining: People may find themselves trying to do a deal with the “higher power” they believe in: "I will never drink again if you spare my life," or "I will return to my faith if you help me through this."
4 Depression: In Irish, when we are sad, we say tá brón orm – ''there is a sadness on me.'' With grief, there is a huge sadness on people as they try to make sense of their loss; in this case, the loss of their health. This can last for some time, as life cannot be taken for granted any more. All of a sudden, making plans for the future is compromised.
5 Acceptance: It can take some time to reach a place in one’s mind where they can truly accept that they have breast cancer. They also have to accept the reality of this diagnosis and loss of health. What aspects of their lives are compromised going forward? Perhaps they had planned to have children. Now they are being told that the chemotherapy may impact their fertility. Such consequences may feel harder to accept, initially, than the actual diagnosis.
Loss of control
After receiving a breast cancer diagnosis, the person can feel as if they have lost control of their life.
It may seem like their very survival is in the hands of the multi-disciplinary team assigned to them. Thoughts like these are fairly normal following such alarming news. It is important to remember that whilst one depends initially on the expertise of the medical team assigned to them, they still have control over their thoughts and how they respond to what is happening. Nobody can take that away.
According to the late Viktor Frankl, a doctor and psychiatrist who survived the Holocaust: “Everything can be taken from a man but one thing: the last of the human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way”
Our thoughts create our experiences. Trying to keep your thoughts as positive as possible will help you keep control over your daily experiences. It will also help reduce anxiety. A very simple yet positive affirmation is, “I can do this”.
Engaging in mindful based practice can also help reduce anxiety. Guided body scan meditation is a wonderful resource that can be found on YouTube, Spotify and Instagram.
Education is empowering. Learn all you can about your illness. Find out about all of the treatment options that are available to you. Then you can make an informed decision on what approach you feel best serves you.
Dealing with side effects
Whatever treatment you opt for may have side effects. Know what to expect and how best to deal with the situation. This helps you to maintain control and can help reduce further stress and anxiety.
Hair loss, for instance, can have enormous repercussions for women as they go through their treatment. Many opt to have their hair shaved in advance so they are in control rather than watch as it falls out. It can help decide in advance if this is the path one wishes to take or opt for wearing wigs, scarves, hats or simply wearing nothing at all. Pre-planning helps maintain a sense of calm and order.
Other side effects may include fatigue, lack of energy, sleeping difficulties, pain and aches. There may be weight loss or weight gain. Certain foods may taste strange or be difficult to keep it down. For those who have had a mastectomy, there is further grief as they have to say goodbye to a part of their body, in order to stay alive. Grief work is hard work, but we must grieve in order to heal.
Seek support
How does one cope with a diagnosis that can be life-threatening?
I believe it is really in a person’s best interest to speak to a counsellor on a regular basis. It is too much to handle on one’s own. Issues around mortality, existential anxiety, body image, loss of femininity and feelings of vulnerability can be shared with the therapist in a safe, warm and confidential space.
The Irish Hospice Foundation offer wonderful support to cancer patients and their families. There are also cancer care support centers in many towns and cities (see panel). They prove invaluable to those who reach out to them, providing many supports including counselling and holistic treatments such as reflexology or pilates.
Often, people who have recovered from cancer volunteer to help others by sharing their experiences and are beacons of light and hope for the cancer patient and their families.
Accept offers of help. No person is an island. Love yourself enough to accept any offers of support that come your way. It is your birth right to be loved and supported as you go through life. Claim it now.
Dealing with a terminal diagnosis
What happens if the diagnosis is terminal?
Unfortunately, it is a reality for many people and their families. Suddenly, they are left with no choice but to face their mortality. Anticipatory grief sets in. They know their time on earth is limited. The goodbyes are going to be sooner rather than later.
What now?
It is never going to be easy thinking about the future following a terminal diagnosis. Despite this fact, it is really important that a person starts thinking about their future straight away.
Having a plan in place can bring a certain amount of inner peace and a sense of relief. They are continuing to keep control and have a say in how the remainder of their days are going to go (in as much as anyone can).
An “end of life plan” will include medical care, palliative care, legal issues and general matters. It will also include funeral wishes and will help the person transition gently from this life to the next. It can also help everybody talk about the reality of what is happening, and help ensure that the forthcoming death of their loved one does not become the “elephant in the room”. The National Council of the Forum on End of Life in Ireland has devised the “Think Ahead” scheme to assist with this matter.
The Irish Hospice Foundation runs a “Hospice Friendly Hospitals Programme” to make sure that end of life, palliative and bereavement care are central to everyday business of hospitals. The programme aims to improve the standard of end of life care in hospitals. There are seven end of life coordinators in position in hospitals across the country.
It is very hard to have to sit and watch a loved one suffer and know there is no cure to be had. Loved ones may try and encourage the patient to go down the road of trials and prolonged treatments as they try and hold on to them for as long as they can.
This may not be in alignment with the patient’s own plans and nobody has a right to try and force a person to do something they have no interest in doing. Always remember, this is your body, your pain, your suffering, your life. Stick to your choice of plan. There are many supports available to the cancer patients and their loved ones. You are never alone. CL
Breast cancer is also a condition that affects males. It is not as common in men, therefore does not get as much press. The experiences will be similar, and men need to go for check-ups if they notice anything unusual about their breasts or in that general area of their bodies.
Helplines
Whatever a person’s cancer diagnosis, we are blessed in this country to have multiple supports available to us in times of need. The main organisations are:
• The Irish Cancer Society Freephone: 1800 200 700
• Irish Hospice Foundation Phone: 01 6793188
• Marie Keating Foundation Phone: 01 6283276
• The Marie Keating Foundation also provides the following link on their website with regard to the many cancer care support centers around Ireland:
Cancer support services in Ireland - Marie Keating Foundation• When it all becomes too much and you just want to talk; the Samaritans are always there to listen. Samaritans 116 123
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